16/03/2020
New Product Alert
Helse Ultrasonic Tip : E2D (Diamond Coated)
Made in Brazil
One of the most infamous canals we chase in endodontics is the second mesio-buccal (MB2) canal in maxillary molars. It’s often referred to as the “fourth canal,” and it is one of the most frustrating aspects of maxillary molar root canals.
Why the MB2 Canal is Important to Treat
One often hears colleagues state that treating the MB2 canal is not very important. They may argue that their root canal treatments have been successful, even without treating MB2 canals. That may be the case empirically; however, we certainly know better. Leaving a canal untreated has its consequences, and let’s not forget the obvious: Root canal treatment is considered incomplete until all, not some, of the tooth’s canals are treated.To put it differently, please ask yourself the following question: If the patient was you or one of your family members, would you be satisfied with partially completed root canal treatment?
How to Find MB2?
Rule of thumb - First think of all other 3 canals and complete the shaping before starting the hunt.
STRICTLY do not use AIROTOR for the same, its way too risky
Use of magnification in form of loupes or microscope is encouraged
MB2 can be far as well as near to MB1
Frequency of MB2 Canals
How often is the MB2 present? Well, the best answer is it’s always there, unless it was looked for at the right location, with the right tools and technique, and couldn’t be found. In other words, almost always. More specifically, studies put the numbers at around 90% to 95% for maxillary first molars and about 90% for maxillary second molars.
Clinically, what seems to matter is how one goes about looking for the MB2. Take, for instance, the use of magnification. One study found that, using dental loupes and a dental microscope, the MB2 canal was located in 41% and 94% of cases, respectively. With no magnification, the frequency of finding the MB2 canal may drop to as low as 17%.
Location of the MB2
The MB2 canal is located palatal to the MB1 canal. One needs to be well aware that it is not in the direction of the palatal canal, but toward the palatal aspect of the tooth. This is key. For the most part (with some exceptions), the MB2 or***ce is about 1.0 mm to 3.0 mm from the MB1 or***ce. In maxillary second molars, the MB2 tends to be closer to the MB1 than in first molars.
Ultrasonics offer the most easiest way to find and treat MB2 as it does not impair vision in the direction of troughing
Kindly Have a look at the pic and video. Anatomy surprises us in many ways.